Exam #3 Nutrition Flashcards
1
Q
A secondary deficiency of a vitamin occurs when
A
absorption is inadequate or excessive amounts are excreted.
Secondary deficiency of a vitamin occurs when absorption is inadequate or excretion is excessive. Inadequate dietary intake of two or more vitamins causes multiple primary deficiencies. Dietary intake below physiologic needs is primary deficiency. Vitamin deficiency almost always occurs when an individual has protein-energy malnutrition.
2
Q
An example of someone who has a relatively high risk for vitamin deficiencies is a(n)
A
elderly man living independently.
Subgroups of the population at risk for vitamin deficiencies include older adults because of decreased vitamin absorption and limited physical and economic resources to purchase and prepare food. Teenage athletes and college students usually consume enough food to ensure adequate vitamin intake. Vitamin deficiencies are rare among breastfed newborn infants.
3
Q
Deficiencies are likely to develop most rapidly with low intakes of vitamin
A
C.
Vitamin C is water soluble; vitamins A, D, and E are fat soluble. Deficiencies of water-soluble vitamins develop more rapidly because they are not stored in the body.
4
Q
The best way to ensure intake of a variety of phytochemicals is to
A
choose whole grains and include at least five servings of fruits and vegetables daily.
The best way to ensure intake of a variety of phytochemicals is to eat a variety of plant-based foods, including whole grains, fruits, and vegetables. Multivitamin supplements do not necessarily contain phytochemicals. Soy-based foods contain only a limited selection of phytochemicals. Dairy products do not contain phytochemicals; herbs and spices may provide some but are used in small quantities and so would not provide significant amounts.
5
Q
The amount of thiamine that the body needs is related to
A
the amount of energy expended.
Thiamine needs are related to metabolic rate (i.e., energy expenditure) because thiamine is a coenzyme in energy metabolism. Thiamine is not directly involved in protein metabolism. The vitamin where requirements are inversely related to skin exposure to sunlight is vitamin D. Physiologic and emotional stress do not affect thiamine needs.
6
Q
Deficiency of thiamine is characterized by
A
muscle weakness, loss of coordination, and tachycardia.
Symptoms of deficiency of thiamine include muscle weakness, loss of coordination, and tachycardia. Dermatitis, altered nerve function, and convulsions are symptoms of vitamin B6 deficiency. Skin rash, hair loss, loss of appetite, and depression are symptoms of biotin deficiency. Gingivitis, poor wound
7
Q
The riboflavin in milk is protected by
A
using nontransparent containers.
Riboflavin is destroyed by ultraviolet light, so it is protected by use of nontransparent containers. Pasteurization destroys pathogenic bacteria. Homogenization prevents separation of milk and cream. Refrigerated storage increases the shelf life of milk.
8
Q
The most significant source of riboflavin in the United States is
A
milk.
The most significant source of riboflavin in the United States is milk. Eggs, meats, and whole grains are all good but lesser sources of riboflavin.
9
Q
Historically, deficiency of niacin was sometimes misdiagnosed as
A
mental illness.
Niacin deficiency was sometimes misdiagnosed as mental illness because of it causes symptoms of dementia. Alcoholism may contribute to niacin deficiency. Niacin deficiency is not generally related to viral infection or iron deficiency anemia.
10
Q
Niacin can be manufactured by the body from the amino acid
A
tryptophan.
Niacin can be manufactured by the body from tryptophan, but not from alanine, arginine, or phenylalanine.
11
Q
Pyridoxine functions in the body as a coenzyme in metabolism of
A
protein.
The active form of pyridoxine, pyridoxal phosphate, functions in the body as a coenzyme in the metabolism of protein and amino acids. It is not involved in metabolism of fat, protein, or energy.
12
Q
A disorder in infants that is associated with inadequate intake of folate during pregnancy is
A
spina bifida.
Inadequate intake of folate during pregnancy is associated with spina bifida in infants. Cystic fibrosis and Down syndrome are genetic disorders. Macrocytic anemia is caused by an overt deficiency of folate, but is not usually found in infants in association with poor maternal intake during pregnancy.
13
Q
Adequate intake of folic acid is especially important for
A
women of childbearing age.
Adequate intake of folic acid is especially important for women of childbearing age because adequate folate status during the first month of pregnancy helps prevent neural tube defects (spina bifida). Pregnant and lactating women have higher folic acid needs than nonpregnant women, but it is important to encourage adequate folic acid intake in all women of childbearing age because neural tube defects occur very early in pregnancy, before most women even realize they are pregnant. Competitive athletes, infants, and young children do not have special needs related to folic acid.
14
Q
An example of a high-folate meal is
A
spinach salad with orange segments.
Good sources of folate include leafy green vegetables (including spinach), legumes, ready-to-eat cereals, and some fruits and juices (including orange). Fish, oatmeal, raisins, pork, and applesauce are not good sources of folate.
15
Q
The type of anemia associated with folate deficiency is _____ anemia.
A
megaloblastic
16
Q
The substance produced by the stomach that is necessary for absorption of cobalamin is
A
intrinsic factor.
The substance produced by the stomach that is necessary for absorption of cobalamin is intrinsic factor. Pernicious factor does not exist; pernicious anemia is caused by cobalamin deficiency. Hydrochloric acid is produced by the stomach, but is used to activate the enzyme pepsin (which helps digest proteins). Pyridoxal phosphate is the active form of pyridoxine or vitamin B6; it is not produced by the stomach or related to absorption of cobalamin.
17
Q
Deficiency of vitamin B12 may cause damage to the
A
nerves.
Deficiency of vitamin B12 may cause damage to the brain, optic nerves, and peripheral nerves. Vitamin B12 deficiency is not associated with damage to the skin, eyes, or heart.
18
Q
An example of a meal high in biotin is a
A
peanut butter and jelly sandwich.
The richest sources of biotin include liver, kidney, peanut butter, egg yolks, and yeast.
19
Q
Pantothenic acid is required for
A
metabolism of carbohydrates, fats, and protein.
Pantothenic acid is part of coenzyme A, required for metabolism of carbohydrates, fats, and protein. It is not involved in absorption of amino acids, conduction of nerve impulses, or regulation of body temperature.
20
Q
Some choline can be synthesized by the body from
A
methionine.
The body can synthesize some choline from methionine, but not enough to meet the needs of the body. The body cannot synthesize choline from glycerol, cholesterol, and tryptophan.
21
Q
Vitamin C deficiency causes scurvy, which is characterized by
A
weakening of connective tissues.
Vitamin C deficiency causes breakdown of connective tissues. Diarrhea, dermatitis, and dementia are characteristic of niacin deficiency. Degeneration of nerves and muscles are not associated with deficiency of a specific vitamin. Vitamin C deficiency may be associated with iron deficiency anemia because vitamin C enhances absorption of nonheme iron. Vitamin C deficiency is not generally associated with weight loss.
22
Q
Lifestyle behaviors that increase vitamin C requirements include
A
smoking cigarettes.
Smokers require more vitamin C than nonsmokers. Shift work, vegan diet, and fat intake do not affect vitamin C needs.
23
Q
Vegetables are likely to be highest in vitamin C if they are
A
stir-fried.
Vegetables are likely to be highest in vitamin C if they are stir-fried. Heat destroys vitamin C, so cooking for the minimum amount of time preserves vitamin C. Vitamin C is water-soluble, so cooking methods that use water cause loss of vitamin C into the cooking liquid. Stir-frying cooks vegetables quickly without adding water. Boiling and canning both cause loss of vitamin C because of use of water. Oven roasting is a slow cooking method so more vitamin C is lost.
24
Q
Vitamin A may be obtained by the body from precursors called
A
carotenoids.
The body can form vitamin A from carotenoids. Calciferols have vitamin D activity. Tocopherols have vitamin E activity. Rhodopsin is a substance formed from vitamin A in the retina.
25
An eye disorder associated with vitamin A deficiency is
xerophthalmia.
Vitamin A deficiency causes xerophthalmia. Myopia (near sight), retinopathy, and double vision are not related to vitamin deficiencies.
26
Vitamins that function as antioxidants in the body include
vitamins C and E.
The two vitamins that function as antioxidants in the body are vitamins C and E.
27
The Adequate Intake (AI) for vitamin D increases in older adults because
their skin is less efficient in synthesizing vitamin D during sun exposure.
Older adults need more dietary vitamin D because their skin is less efficient in synthesizing vitamin D during sun exposure. Their ability to absorb vitamin D and convert vitamin D to its active form has less effect of vitamin D needs. They do not necessarily require more total vitamin D than younger adults for bone health; they need more from foods because their skin manufactures less.
28
Symptoms of vitamin D toxicity include
high levels of calcium in the blood and urine.
Vitamin D toxicity causes high levels of calcium in the blood and urine because vitamin D enhances calcium absorption. Lethargy and loss of coordination indicates thiamine deficiency. Rickets, osteomalacia, and osteoporosis indicate vitamin D deficiency (not toxicity). Blistered skin, joint pain, and liver damage are signs of vitamin A toxicity.
29
Vitamin E requirements are related to intake of
polyunsaturated fats.
Vitamin E needs are related to intake of polyunsaturated fats because vitamin E prevents their oxidation. Vitamin E needs are not related to intakes of protein, vitamin C, and monounsaturated fats.
30
An example of a meal high in vitamin K is
stir fried beef with broccoli.
The best source of vitamin K is green leafy vegetables, such as broccoli. Dairy products, meats, cereals, and fruit provide smaller amounts.
31
Long-term antibiotic use may be associated with vitamin K deficiency because antibiotics
kill gut bacteria that synthesize vitamin K.
Antibiotics kill gut bacteria that synthesize vitamin K, so long-term use of antibiotics may cause vitamin K deficiency. Antibiotics do not interfere with vitamin K absorption, break down dietary vitamin K in the intestines, impair blood clotting, or increase vitamin K requirements.
32
The first step to ensuring adequate intake of vitamins is to
ensure that the diet includes a variety of foods from all of the food groups.
The best way to ensure adequate intake of vitamins is to start with a diet that includes a variety of foods from all the food groups. Reliance on supplements and food fortification do not result in an overall optimal diet. Use of supplements by specific subgroups of the population may be a second step in ensuring dietary adequacy, but would not be the first step.
33
Many Americans use vitamin supplements on a regular basis because
it is easier than making dietary and behavioral modifications.
It is often easier to take vitamin supplements than to make dietary and behavioral modifications to ensure that the diet provides adequate nutrients. Supplements do not taste good, and supplements are not necessary for good health for most people. Supplements are also not necessarily cheaper than foods containing a variety of nutrients.
34
If a woman who drinks a cup of decaffeinated coffee in the morning, a cup of fruit juice with lunch, 6 cups of water throughout the day and a cup of tea at bedtime, her fluid intake would be considered
optimal.
This woman’s total fluid intake for the day is 9 cups, the recommended amount for women. Minimum fluid intake for health is around 4 cups; intake below this would be considered dangerously low. Fluid intake can be too high, but the specific amount that causes water intoxication is unknown.
35
Hard water contains high levels of minerals such as
calcium and magnesium.
Hard water contains calcium and magnesium. Some natural water sources contain iron (this water may stain sinks and appliances brown). Lead is considered a contaminant in water. Softened water contains sodium. Zinc, sulfur, and potassium are not usually found in water.
36
Interstitial fluid is the body fluid
between the cells.
Interstitial fluid is the body fluid between the cells. The fluid within the cells is intracellular fluid; the fluid outside the cells is extracellular fluid; the fluid in the bloodstream is blood plasma.
37
Within the body, water helps to
regulate body temperature.
Within the body, water helps to regulate body temperature by absorbing and distributing heat throughout the body and via perspiration. Lipids do not dissolve in water. Water does not contain energy. Nerve fibers are insulated by myelin, not water.
38
Maintenance of physiologic equilibrium within the body is known as
homeostasis.
Maintenance of physiologic equilibrium within the body is known as homeostasis. Hemostasis is not a recognized term. Water balance is only one aspect of homeostasis. Metabolic regulation describes homeostasis, but is not the recognized term for it.
39
The hormone that causes the body to decrease sodium excretion is called
aldosterone.
The hormone that causes the body to decrease sodium excretion is aldosterone. Adrenaline is released in response to stress. Alanine is an amino acid, not a hormone. ADH causes the kidneys to decrease water excretion.
40
The primary intracellular electrolyte is
potassium.
The primary intracellular electrolyte is potassium. Sodium is the primary extracellular electrolyte. Calcium and magnesium are not electrolytes.
41
In an older adult who is usually very alert, disorientation may be a sign of
dehydration.
Disorientation may be a sign of dehydration, which is common in older adults, partly because their thirst mechanism is diminished. Iron deficiency anemia causes tiredness, but not disorientation. Severe malnutrition may affect mental acuity, but is less likely than dehydration. Edema causes swelling, but does not usually affect orientation.
42
Edema may be caused by inadequate intake of
protein.
Edema may be caused by inadequate intake of protein if protein levels in the body become so low that cellular fluid levels become imbalanced. Edema may be caused by high, not low, sodium levels and is not caused by low chloride or potassium levels.
43
The term bioavailability means the
amount of a mineral that can be absorbed by the body from a food.
Bioavailability is the amount of a mineral that can be absorbed by the body from a food. It is generally lower than the total amount of the mineral in a food. It may be related to the ratio of free to bound mineral in a food, but that is only one of many factors affecting bioavailability. It is not related to the amount excreted by the body.
44
Daily dietary calcium intake affects
bone calcium levels.
Long-term dietary calcium intake affects bone calcium levels. Calcium does not affect body temperature. The body maintains steady levels of calcium in the blood and muscles, using calcium from bone if dietary intake is insufficient.
45
Beverages that contain substances that decrease absorption of calcium include
tea.
Tea contains oxalic acid and tannins, both of which decrease absorption of calcium. Milk contains lactose and vitamin D which increase calcium absorption. Orange juice and bottled water do not have a significant positive or negative effect on calcium absorption.
46
Lifestyle changes that may help prevent development of osteoporosis include
taking a 30 minute walk most days.
Taking a 30 minute walk most days may help prevent development of osteoporosis because regular exercise stimulates an increase in bone density. Eating vegetable versus animal protein, increasing intake of fruit, and use of multivitamin supplements are unlikely to prevent osteoporosis (although they may have other health benefits).
47
An example of a food high in phosphorus is
cheese.
Foods high in phosphorus include dairy foods (such as cheese). Many processed convenience foods and soft drinks also contain phosphorus as additives. Fruits, vegetables, and rice are not good sources of phosphorus
48
A good source of calcium for someone who follows a strict vegetarian (vegan) diet would be
a bean burrito.
A good vegan source of calcium is a bean burrito because legumes contain calcium. Coconut milk and pasta salad are not good sources of calcium. Skim milk is not included in a vegan diet.
49
Magnesium deficiency may occur in association with
excessive vomiting and diarrhea.
Magnesium deficiency may occur secondary to excessive vomiting and diarrhea. Lactation, type 1 diabetes, and dehydration due to heat exposure do not cause magnesium deficiency.
50
Of the following, the food choice that contains the least sodium is
corn on the cob.
The food choice that contains the least sodium is corn on the cob. This is the least processed of all these forms of corn. Food processing usually involves addition of sodium.
51
A sodium intake of 2100 mg daily of a healthy adult would be considered
below the maximum recommended level.
A sodium intake of 2100 mg daily is below the maximum level recommended by the National Research Council (2400 mg/day) and the American Heart Association (2300 mg/day). The AI is 1500 mg. There is no recommended range for sodium intake, just the AI and upper limits.
52
Signs of potassium deficiency include
muscle weakness and confusion.
Signs of potassium deficiency include muscle weakness and confusion. Excessive thirst and urination is a sign of high blood glucose levels associated with uncontrolled diabetes. Shortness of breath and dizziness may be caused by cardiac failure or other causes. Twitching of muscles and convulsions may have many causes but are not caused by potassium deficiency.
53
Foods that contain chloride usually also contain
sodium.
Chloride in foods is usually associated with sodium. It is not usually found in foods in association with calcium or magnesium. Some salt substitutes contain potassium chloride, but chloride is not associated with potassium in foods.
54
Young women require more dietary iron than young men
to replace blood losses during menstruation.
Young women require more dietary iron than young men to replace blood losses during menstruation. There is no difference between iron absorption or hemoglobin recycling in young men versus young women. Higher iron intake does not compensate for lower muscle mass in women.
55
The form of dietary iron that is absorbed most easily is
heme iron.
Heme iron is absorbed most easily. Nonheme iron is absorbed less efficiently. Iron in foods is not described as “free.” Iron supplements contain nonheme iron which is absorbed less efficiently.
56
The effects of iron deficiency are caused by
decreased ability of the blood to transport oxygen.
The effects of iron deficiency are caused by decreased ability of the blood to transport oxygen. Blood pressure, blood clotting, muscle fibers, and brain cells are not immediately affected by iron deficiency.
57
Hemosiderosis, storage of too much iron in the body, is most likely to occur
a man who drinks 5 or more alcoholic beverages every night.
Hemosiderosis is most likely to occur in a man with a high intake of alcohol. Adolescents who have high intakes of soft drinks are likely to have high intakes of phosphorus. Toddlers who prefer to drink milk rather than eating meals may develop iron deficiency. Pregnant women who take iron supplements are unlikely to store too much iron because iron needs are very high during pregnancy.
58
In countries where the staple food source is unleavened bread made from whole grains, zinc deficiency may be prevented by
making breads with yeast.
Zinc deficiency may be prevented by making breads with yeast; the yeast breaks the bond between the zinc and phytic acid which prevents it from being absorbed. Eating refined grains would result in even lower zinc intake; fortification of grains does not include adding zinc; and soaking grains before making bread does not release the zinc from the phytic acid.
59
The main source of iodine in the United States is
fortified table salt.
The main source of iodine in the United States is fortified table salt. Seafood is a good source but most Americans do not eat it often enough for it to be their main source of iodine. Dairy products may contain some iodine, depending on the animal food, but this is not a reliable source. Residues of cleaning products may provide some dietary iodine, but this is not usually enough to be significant.
60
Deficiency of iodine reduces thyroxine production, which causes
lethargy and weight gain.
Deficiency of iodine causes lethargy and weight gain. Microcytic anemia may be caused by iron deficiency. Fever and dehydration are not related to nutrient deficiencies. Delayed wound healing may be caused by deficiencies of zinc or vitamin C.
61
Dietary fluoride is important to
increase the strength of tooth enamel.
Dietary fluoride is important to increase the strength of tooth enamel. It does not decrease staining or sensitivity of teeth or stimulate production of saliva.
62
In the United States, low intake of selenium may be associated with increased risk of
cancer.
Low intakes of selenium may be associated with increased risk of cancer because selenium functions as an antioxidant which protects cells from damage. Selenium is not associated with risk of osteoporosis, hypertension, or type 2 diabetes.
63
Wilson’s disease is an inherited disorder that causes excessive accumulation of
copper.
Wilson’s disease causes excessive accumulation of copper. Excessive accumulation of iron is called hemosiderosis. Excessive accumulation of zinc and chromium does not have specific names.
64
A good dietary source of chromium is
oatmeal.
Oatmeal is a good dietary source of chromium because it is a whole grain. Good sources do not include refined grains (such as pasta), fruits, and vegetables.
65
Apart from lowering dietary sodium intake, dietary changes that may help decrease high blood pressure include
increasing intake of calcium and magnesium.
Dietary changes that may help decrease high blood pressure include increasing intake of calcium and magnesium. This could be accomplished by increasing, rather than decreasing, intake of dairy products. Intake of vegetable versus animal protein and replacing saturated fats with polyunsaturated fats do not decrease blood pressure, although these changes may have other health benefits.
66
A wife who blames her high blood pressure on her husband’s preference for salty foods is an example of
projection.
A wife who blames her high blood pressure on her husband’s preference for salty foods is an example of projection. She is projecting her unhealthy behaviors on her husband instead of taking responsibility for her own health. Denial would be ignoring the problem. Chaining would be associating one behavior with another. Reframing would be replacing negative expectations and associations with positive ones.
67
The fuel for all body processes that traps energy released from food is (are)
adenosine triphosphate.
The body catabolizes nutrients and their energy is trapped in adenosine triphosphate (ATP), the fuel for all processes that require energy in the body. Electrons do not store energy. Acetyl coenzyme A is a substance that is produced in the sequence of reactions as nutrients are metabolized in the mitochondria. Glucose-6-phosphate is a substance that is produced in the sequence of reactions in the metabolism of carbohydrate.
68
Energy-supplying nutrients are eventually broken down to
carbon dioxide and water.
All energy-supplying nutrients are eventually catabolized to carbon dioxide and water. Glucose and fatty acids are products of digestion of carbohydrates and fat; they are not end products of metabolism. Ketone bodies are produced when fat is used for energy; they are later broken down to carbon dioxide and water. Urea is a byproduct in the breakdown of amino acids for energy. Free radicals and oxygen are not generally produced in metabolism of energy-yielding nutrients.
69
The total amount of energy in a bowl of soup that contains 5 g of protein, 2 g of fat, and 20 g of carbohydrate is _____ kcals.
118
Protein provides 4 kcals/g; fat provides 9 kcals/g; carbohydrate provides 4 kcals/g. Therefore, the soup contains (5 × 4) + (2 × 9) + (20 × 4) = 20 + 18 + 80 = 118 kcals.
70
Aerobic glycolysis occurs in the
mitochondria.
Aerobic glycolysis occurs in the mitochondria. Anaerobic glycolysis occurs in the cytoplasm. The cell nucleus and membrane are not sites of energy metabolism.
71
Before they enter the tricarboxylic acid (TCA) cycle, fatty acids are broken down to
acetyl coenzyme A.
Fatty acids are broken down to acetyl coenzyme A before they enter the TCA cycle. Keto acids are formed as protein is metabolized to release energy. Pyruvic acid is a substance that is formed as nutrients are converted to acetyl coenzyme A. Ketone bodies are formed when fat is metabolized to release energy and there is insufficient oxygen for aerobic glycolysis.
72
In order to be used as an energy source, amino acids have to undergo
deamination.
Amino acids undergo deamination, removal of the amino group, before they can be metabolized to release energy. Beta-oxidation is part of the process of metabolism of fatty acids. Glycogenesis is the process by which glycogen is formed from glucose. Ketogenesis is the formation of ketone bodies when fat is used for energy and there is insufficient oxygen for aerobic glycolysis.
73
Energy for short-term, high-intensity activities such as sprinting is obtained mostly via
anaerobic pathways.
Anaerobic pathways metabolize mostly glycogen for short-term, high-intensity activities. Adrenaline release may or may not stimulate this metabolism. Aerobic pathways are used for longer-term, moderate-intensity activities. Oxidation of fatty acids occurs mostly in long-term, moderate-intensity activities.
74
If someone goes on a long hike, after 4 hours most of their energy will be obtained from
fatty acids.
In long-term, moderate intensity exercise, the muscles use more fatty acids and less glucose and glycogen. Amino acids may used to provide glucose for the brain when glucose and glycogen stores are depleted, but would not be the major source of energy for working muscles.
75
Basal metabolic rate represents
the amount of energy required to support life-sustaining processes.
Basal metabolic rate is the amount of energy required to support life-sustaining processes. It is close to the amount of energy expended while at rest (resting energy expenditure), although this includes some of the energy used to digest food and for activity. Basal metabolic rate, physical activity, and thermic effect of food make up total energy expenditure.
76
Of the following, the person who would be expected to have the highest energy expenditure is a(n)
active man.
An active man would have the highest energy expenditure. Generally, men have higher energy expenditures than women and active people have higher energy expenditures than sedentary people.
77
The process by which the body uses energy to adjust to changes in environmental conditions is called
adaptive thermogenesis.
Adaptive thermogenesis is the process by which the body uses energy to adjust to changes in physical and biologic conditions. Homeostasis refers to the overall process of maintaining a constant environment in the body in response to changing conditions. Thermoregulation refers to maintenance of constant temperature in the body. The thermic effect of food is the energy used to digest, absorb, metabolize, and store food.
78
Stretching and exercises that increase flexibility are important for
moving muscles to their full extent without injury.
Exercises that involve stretching and increasing flexibility help move muscles to the full extent without injury. Aerobic exercise maintains cardiovascular fitness and builds endurance. Resistance exercise increases muscular strength.
79
The amount of physical activity needed to maintain physical fitness depends on the
intensity of the activity.
The amount of physical activity needed to maintain physical fitness depends on the intensity of the activity. The more intense the activity, the shorter the amount of time needed to maintain fitness. Time of day, ambient temperature, and flexibility of the individual do not affect the amount of physical activity needed to maintain physical fitness.
80
Health benefits generally associated with strength training include
increased bone density.
Strength training forces bones to react to the stresses placed on them by becoming stronger. Strength training may promote weight loss, depending on the type of exercise, but this is not necessarily so. Exercise overall may decrease risk of some types of cancer and improve sleep patterns, but this is not specifically associated with strength training.
81
The factor that is most effective in increasing muscle mass is
exercise.
Exercise is essential for increasing muscle mass. Adequate intake of protein helps provide the building materials for muscles to grow in response to exercise, but most diets provide sufficient protein without needing a high protein intake or amino acid supplements. Fat intake per se is not related to increasing muscle mass.
82
An athlete’s kcal intake is appropriate if he or she
maintains a competitive and healthy weight.
The best index of appropriate energy intake is maintenance of a competitive and healthy weight. Different percentages of body fat may be appropriate for different types of athletes and different individuals. Specific kcal needs of individuals vary greatly. Hunger is subjective and does not necessarily indicate whether energy intake is appropriate.
83
If an athlete weighed 150 lbs at the beginning of an athletic event and weighed 146 lbs at the end of the event because of water lost in sweat, their athletic performance towards the end of the event would be
impaired.
Loss of 4 lbs by a 150 lb athlete represents loss of 2.7% of body weight. Loss of 2% to 3% of body weight impairs performance, causing an increase in body temperature, confusion, and loss of coordination.
84
The best indicator of fluid loss during a workout is
loss of body weight.
Loss of body weight is the best indicator of fluid loss during a workout. Thirst is unreliable. Urine volume may help indicate hydration status but is not definitive. Body temperature is affected by other variables.
85
Sports drinks may be preferable to water for athletes who
exercise for longer than 90 minutes.
Sports drinks may be beneficial for athletes who exercise for longer than 90 minutes, because they provide some carbohydrates and electrolytes. Otherwise, fluid replacement is the main priority and water is just as beneficial as sports drinks. With shorter bouts of exercise, normal food intake replaces nutrient losses.
86
An example of a good food for replacing glycogen stores is
breakfast cereal.
Foods high in carbohydrate, such as breakfast cereal, help replace glycogen stores. Raw carrots are low in energy; string cheese and scrambled eggs provide mostly protein and fat.
87
Carbohydrate loading increases glycogen stores in muscles by combining
rest and increased carbohydrate intake.
Carbohydrate loading is most effective in increasing glycogen stores when high carbohydrate intake is combined with tapered exercise 3 days before competition to allow the muscles to rest.
88
The person who is mostly likely to need to be concerned about the adequacy of their protein intake is a
female vegetarian runner with a low kcal intake.
Female athletes often do not consume sufficient kcals and so some protein may be used for energy, which increases requirements. Also, vegetarians may need more protein to provide sufficient essential amino acids. Most body builders and moderately active men and women are likely to consume enough protein in their regular diet.
89
When an athlete eats more protein or amino acids than he or she needs, the extra amino acids are
deaminated and used as an energy source.
Excess amino acids are deaminated and used as an energy source. The body cannot store amino acids or protein and only increases muscle mass in response to exercise.
90
Athletes who exercise regularly are able to exercise for longer, partly because their body uses more energy from
fat.
Regular exercise increases the body’s ability to use energy from fat. This spares glycogen stores and exercise can continue for longer. Protein and amino acids are used only when glycogen and glucose (carbohydrate) stores are exhausted; this would take longer in athletes who exercise regularly.
91
An example of an athlete who is most likely to benefit from a multivitamin/mineral supplement that provides 100% of the DRI is a
gymnast.
Athletes with thin builds, such as gymnasts, may limit their food intake to control their energy intake and may therefore benefit from a multivitamin/mineral supplement. Most athletes consume plenty of food and therefore plenty of vitamins and minerals. For these athletes, adding supplements could result in intake of toxic levels of some nutrients.
92
An ergogenic aid that may have proven beneficial effects is
creatine.
There is some evidence that creatine may enhance energy levels. Ginseng, carnitine, and arginine (an amino acid) have not been found to have any proven effect on athletic performance.
93
An example of a beverage that may have an ergogenic effect is
coffee.
Coffee contains caffeine which helps increase fatty acid oxidation and spares glycogen. Milk contains protein, but amino acids have not been proven to have ergogenic benefits. Beer contains alcohol which is not an ergogenic acid. Ginseng has not been shown to have any ergogenic value.
94
Competitive athletes are vulnerable to marketing claims about supplements and ergogenic aids because
a slight increase in performance can allow them to win.
Competitive athletes are great targets for marketing supplements and ergogenic aids because very small differences in performance can make the difference between winning and losing. Supplements are usually more expensive than buying a balanced diet. There is a considerable amount of knowledge about appropriate foods for athletes. Healthful foods are generally more readily available than supplements.
95
During exercise, the digestive process
slows down.
During exercise, blood flow to muscles increases and blood flow to the digestive tract decreases, so the digestive process slows down. Metabolism of fat increases and metabolism of carbohydrate decreases during exercise, but this does not affect digestion of fat and carbohydrate.
96
The process by which one person learns a healthful lifestyle behavior by following the example of another person is known as
modeling.
Modeling is replicating or imitating the behavior of someone else, using them as a model or example for your own behavior. Chaining is linking a healthful behavior with another behavior in daily life. Projecting is blaming one’s behavior on outside influences or other people. Replicating is a research terms that refers to whether a similar study will produce the same results as an earlier study.
97
An individual has a distorted body image when
his or her perception of his or her body differs from reality.
A distorted body image means that an individual’s perception of his or her body differs from reality. The distortion is the difference between perception and reality rather than an actual distortion in body proportions. Distorted body image is often associated with dissatisfaction with personal appearance, but an individual may have an accurate body image and still be dissatisfied.
98
Cultural influences have had a greater influence on body perception during the past few decades because of the increase in
mass media.
Mass media present “desirable” body images that affect how people view their own bodies. Food availability and medical services do not affect body perception. Health knowledge may affect how we view our bodies, but to a lesser degree than mass media.
99
A healthy and positive body image is associated with
realistic evaluation and acceptance of our positive and negative attributes.
Individuals with a healthy and positive body image evaluate themselves realistically and accept their positive and negative attributes. They may or may not adopt healthy lifestyle behaviors, achieve a healthy weight and body composition. They will probably tend to be less prejudiced against overweight and underweight individuals, but this is not necessarily so.
100
Body mass index (BMI) is
weight in kilograms divided by the square of height in meters
Body mass index = weight (kg) ÷ height (m)2. The ratio of waist circumference to hip circumference is known as waist-to-hip ratio. Body mass index indicates degree of overweight or underweight but not personal satisfaction with current body weight. Weight divided by waist circumference is not used in clinical practice..
101
Risk of mortality in adults is lowest for those with a body mass index that is between
20 and 25.
Lowest risk of mortality is associated with a BMI between 20 and 25. Risk of mortality increases slightly with lower BMIs and increases exponentially with higher BMIs.
102
The increased risk of mortality in individuals with a very low body mass index is probably related to
low levels of lean body mass.
Risk of mortality in individuals with a very low BMI is probably related to low levels of lean body mass, often related to smoking or disease. Low levels of body fat and inadequate fat intake are less likely to be associated with increased risk of mortality. Failure to store energy from ingested food is rare.
103
Fat stored in the abdominal area is called _____ fat.
visceral
Fat stored in the abdominal area is called visceral fat. Gynoid fat is stored around the hips, buttocks, and thighs. Essential fat protects vital organs in the body. Subcutaneous fat is all storage fat, regardless of the site of storage.
104
Metabolic syndrome is associated with increased risk of
diabetes mellitus.
Metabolic syndrome increases risk of atherosclerosis, heart disease, stroke, and diabetes mellitus. Even though the thyroid gland regulates body metabolism, it is not associated with metabolic syndrome. Digestive disorders, leukemia, and lymphoma are also not related to metabolic syndrome.
105
Obesity may be a contributing factor in development of
sleep apnea.
Obesity increases risk of sleep apnea. Risk of osteoporosis is actually inversely related to obesity. Alcoholism is not related to obesity. Multiple sclerosis is an autoimmune disease and is not related to obesity.
106
Adverse effects of obesity that are not life threatening but decrease quality of life include
arthritis.
Obesity increases risk of all of these disorders. Arthritis is not life threatening, but decreases quality of life. Heart disease, diabetes mellitus, and high blood pressure all increase risk of mortality.
107
Restrained eating is defined as
limiting food intake to less than natural appetite.
Restrained eating means restricting food intake below one’s natural appetite. Avoiding certain types of foods is picky eating. Restrained eaters may or may not limit food intake to certain times of day. Ceasing to eat when hunger has been satisfied would be considered normal eating.
108
If an individual says they have a desire for dessert after they have eaten a meal they are describing their
appetite.
Desire for food is appetite. Physiological need for food is experienced as hunger. Satiety describes a lack of desire for more food, often accompanied by a feeling of fullness. Thirst describes a desire for fluid.
109
For a man, a total body fat level of 18% is considered
healthy.
The recommended range for total body fat in men is 15% to 20%. Therefore, 18% is considered a healthy amount of total body fat.
110
If a health practitioner wants to assess whether an underweight woman is too thin, he or she may ask her
whether she menstruates regularly.
Failure to menstruate indicates that body fat levels are too low. Recent weight loss, appetite, and family weight status may help understand why the woman is thin, but would not indicate whether her weight is below a healthy range.
111
If a woman’s waist measurement is 34 inches and her hip measurement is 40 inches, her waist-to-hip ratio would be considered to be
associated with a high risk of chronic disease.
This woman’s waist-to-hip ratio is 34 ÷ 40 = 0.85. A healthy waist-to-hip ratio for women is less than 0.8. Therefore, this woman’s waist-to-hip ratio is considered to be associated with a high risk of chronic disease.
112
Compared to women, it appears to be easier for men to lose weight because
visceral fat is lost more easily than lower body fat.
Men generally have more visceral fat, which is easier to lose than lower body fat (which is more common in women). Willpower and levels of activity are not different in men versus women.
113
Excess fat is stored in our bodies as
triglycerides in adipocytes.
Excess body fat is stored as triglycerides in special cells called adipocytes. The liver cannot store fatty acids. Glycerol is not stored in the body. Excess fat cannot be converted to glycogen.
114
The increase in the number of adipocytes in the body during growth spurts is known as
hyperplasia.
The increase in number of adipocytes is known as hyperplasia. Hypertrophy refers to an increase in cell size. Mutation describes changes that occur in cells, for example in cancer or genetic defects. Maturation describes a time-related process.
115
The best way to accurately measure body fat levels is to use
underwater weighing (densitometry).
Underwater weighing is considered the “gold standard” for measuring body fat levels. However, body mass index, triceps skinfold thickness, and bioelectric impedance analysis are often used to estimate body fat levels because they are easier to measure.
116
To lose a pound of body fat in a week, daily energy expenditure would have to increase by about _____ kcals.
500
One pound of fat represents 3,500 kcals. To lose a pound of fat in a week, daily energy expenditure would need to increase by 3,500 ÷ 7 = 500 kcals.
117
The causes of obesity are largely
multifactorial.
May factors contribute to obesity, including genetic, cultural, hormonal, and environmental factors. The cause of obesity is therefore multifactorial.
118
According to set point theory, if weight or fatness falls below the level perceived to be appropriate by the body, the individual will
experience an overall increase in hunger drive.
Set point theory suggests that our bodies defend a set level of body fatness. Therefore if weight or fatness falls below this level, the individual is likely to experience increased hunger until they regain the weight. Unfortunately, it is not easy to develop a new, lower set point for body weight. Appetite for high-fat foods does not necessarily increase. Physical activity level is not affected by body weight in relation to set point.
119
Factors that appear to help reduce the body’s set point for body weight and body fatness include
regular aerobic exercise.
It is very difficult to reduce the body’s set point for body weight and body fatness; regular aerobic exercise seems to be the most effective intervention. Protein intake, weight loss medications, and vitamin supplements do not affect set point.
120
A major problem associated with cycles of weight loss and weight gain is
loss of sensitivity to physiologic hunger cues.
Cycles of weight loss and regain result in loss of sensitivity to physiologic hunger cues. The body’s ability to metabolize body fat is unaffected. Usually individuals who lose and regain weight feel loss of control rather than empowerment. Weight cycling does not generally affect hormone balance.
121
To maintain a healthy weight, the most important goals are related to changes in
behaviors.
Maintaining a healthy weight depends on adopting healthy behaviors and attitudes towards food rather than focusing on food intake or physical activity alone. Supplement use does not influence body weight.
122
The most important factor in setting behavioral goals is
individual habits and preferences.
Behavioral goals must be tailored to each client’s habits and preferences. Their willingness to exercise is only one of many factors to consider. The amount of weight loss desired is not the focus of behavioral change. The skill of the health practitioner may help or hinder the process of determining behavioral goals, but is not the focus of the process.
123
If a client wants to relearn to pay attention to hunger and satiety cues, they may find it helpful to
keep a journal of perceived emotions.
A journal of perceived emotions (especially if it also includes foods eaten) may help a client to relearn how to pay attention to hunger and satiety cues. Establishing a regular pattern of meals may help a client develop healthful eating habits, but would not help them identify their hunger and satiety. Eating all food at home is probably not realistic for most clients. Avoiding eating until very hungry is likely to result in erratic food intake and overeating.
124
The best way to maintain lean body mass is to
exercise regularly.
Exercise helps maintain lean body mass (muscle). Weight loss causes some loss of lean body mass and ensuring adequate protein intake will help maintain lean body mass, but these effects are less significant than that of exercise. Decreasing dietary fat intake does not affect lean body mass.
125
National programs that aim to reverse the trend of increasing body weight should focus on
achievement of a healthier body weight.
Achievement of healthier body weight is a more realistic goal than maintenance of ideal body weight; it is more likely to encourage success. Monitoring annual weight changes allows researchers to describe trends, but not to reverse them. Smoking cessation improves health, but is more likely to be associated with weight gain than with weight loss.
126
Our main attitude towards food should be one of
enjoyment.
We should be able to enjoy and take pleasure in eating foods. At times we may need to exercise self-control when we are not hungry. Eating contributes greatly to our quality of life and should be more than a necessity in our lives. We can make healthy food choices but this should not become a joy-killing focus of our lives.
